A systematic review of experience of 180‐W XPS GreenLight laser vaporisation of the prostate in 1640 men

Abstract

ObjectiveTo systematically review the literature regarding clinical outcomes of 180-W XPS GreenLightâ laser (GL) vaporisation for the treatment of lower urinary tract symptoms (LUTS) related to benign prostatic hyperplasia (BPH). MethodsRecent publications were identified in the field of 180-W GL vaporisation for the treatment of LUTS due to BPH. We searched for peer-reviewed original articles in the English language. Search items were: '180W lithium triborate laser' or '180W greenlight laser' or '180 watt lithium triborate laser' or '180 watt greenlight laser' or 'XPS greenlight laser'. In all, 30 papers published between 2012 and 2014 matched this search. Of these, 10 papers were identified dealing with consecutive cohorts of patients treated with the 180-W XPS GL ResultsThe 10 papers included a total experience of 1640 patients. The only randomised controlled trial in this field compares 180-W with transurethral resection of the prostate (TURP). Functional outcomes and prostate volume reduction after GL vaporisation were similar to TURP. Catheterisation time and hospital stay were shorter in patients undergoing 180W XPS GL vaporisation (41 and 66 h vs 60 and 97 h, respectively). Four papers compared the 180-W XPS system to former GL devices showing increased operation time efficiency and comparable postoperative voiding results and adverse events. One paper defined the learning curve to achieve an expert level according to the speed of the procedure and the effectiveness of volume reduction was met after 120 procedures. ConclusionThe 180-W XPS GL offers shorter operation times than former devices. In the one randomised controlled trial comparison with TURP, volume reduction and functional results were comparable to those of TURP. Longer term studies are required.

Perioperative Changes and Progress in Photoselective Vaporization of the Prostate with GreenLight XPS 180 W System: A Single Center Experience

“…Likewise the effective LT could be significantly reduced more than 30% in our 5 year time course and is shorter than the median LT of recent GOLIATH study with median 41 min (range 14–140) and even shorter than recently published data by Gueli et al [12] with an LT of median 55 min comparing prostate volumes >100 mL [7, 12, 14]. …”

“…The significant reduction of OT and LT does not only emphasize the effectiveness and efficacy of GL-XPS, it also shows the consistency of the method, despite multiply surgeons. This finding may be in slight contrast to the suggested median of 120–150 cases per surgeon to reach an expert level in GL-XPS, although this was clearly not the scope of our analysis [12, 14, 19-21]. Bouchier-Hayes et al [6] confirmed that even a novice surgeon with a previous experience level of just 5 cases in GL-XPS is non-inferior in performing GL-XPS in comparison to TURP, using the 80 W laser system results in 2010.…”

“…The significantly improved OT efficiency may be explained not only by growing experience at a high volume center for GL-XPS, but also by utilizing 180 W energy of GL-XPS leading to a faster and more efficient photoselective vaporization of the prostate compared to 80 W laser systems (median 80 min; range 60–120) before [14, 15]. …”

Photoselective vaporization of the prostate with the 180-W XPSGreenlight laser: Five-year experience of safety, efficiency, and functional outcomes

“…7,16 Since its introduction to the urological armamentarium, several studies reported its superiority to monopolar TURP with shorter hospitalization, shorter catheterization time and faster time to clinical stability. 16,17 More recent studies have demonstrated excellent outcome of 180W XPS GL PVP over a period of 2 years. 6 The current study is unique as it is the first study to the best of our knowledge to report 5-year durability outcomes.…”

Urininkontinenz beim Mann – ein Tabuthema

“…Neben der TUR-P, die als Goldstandard zur Deobstruktion der Prostata gilt, gibt es auch neuere alternativen Verfahren wie zum Beispiel die transurethrale LASER-oder Plasma-Vaporisation der Prostata mit bis anhin ähnlichen postoperativen Ergebnissen im mittelfristigen Verlauf [18,19]. Bei minimalinvasiven Verfahren wie zum Beispiel dem UroLift, ist die Datenlage zu den postoperativen Ergebnissen aktuell ungenügend [20].…”